Martens M F, Hendriks T, Wobbes T, De Pont J J
Department of General Surgery, Academic Hospital, Nijmegen, The Netherlands.
Br J Cancer. 1992 May;65(5):649-54. doi: 10.1038/bjc.1992.139.
Collagen synthesis in intestinal anastomoses has been measured in rats after in vivo administration of cytostatics. The cytostatics were administered during 5 consecutive days either intravenously or intraperitoneally. On day 3 of the course the rats received both an ileal and a colonic anastomosis. The animals were sacrificed 3 and 7 days after operation. The cytostatics regimen used was a combination of 5-fluorouracil, bleomycin and cisplatinum in a dose of 10, 2 and 0.35 mg kg-1 day-1, respectively. In an additional group, a twice higher dose was given intraperitoneally. Three days after operation a severe inhibition of the collagen synthesis was observed in all the cytostatics treated groups, both in ileum and in colon. The effects of intraperitoneal administration were much more pronounced than those observed after an equal dose given intravenously. Seven days after operation the collagen synthesis in the intravenously treated groups was restored to the level of the control group. However, in the intraperitoneal groups the collagen synthesis in ileal anastomoses was still inhibited. Thus, cytostatics suppress collagen synthesis in intestinal anastomoses. The effect is more severe after intraperitoneal than after intravenous administration, confirming our earlier hypothesis that the former mode of administration comprises a higher risk for anastomotic integrity.
在大鼠体内给予细胞抑制剂后，对肠吻合处的胶原蛋白合成进行了测定。细胞抑制剂连续5天通过静脉注射或腹腔注射给药。在疗程的第3天，大鼠接受了回肠和结肠吻合术。在术后3天和7天处死动物。所使用的细胞抑制剂方案是5-氟尿嘧啶、博来霉素和顺铂的组合，剂量分别为10、2和0.35毫克/千克/天。在另一组中，腹腔注射的剂量加倍。术后3天，在所有接受细胞抑制剂治疗的组中，回肠和结肠的胶原蛋白合成均受到严重抑制。腹腔给药的效果比静脉给予同等剂量后观察到的效果更为明显。术后7天，静脉治疗组的胶原蛋白合成恢复到对照组水平。然而，在腹腔注射组中，回肠吻合处的胶原蛋白合成仍受到抑制。因此，细胞抑制剂会抑制肠吻合处的胶原蛋白合成。腹腔给药后的效果比静脉给药更严重，这证实了我们之前的假设，即前一种给药方式对吻合完整性的风险更高。
